Overmedication Causing Weight Gain

[thyroidpal]

How can I stop the weight gain and fatigue?  I've just had my yearly check up with my Endocrinologist and at his initial review of my lab results he said he wanted to keep things status quo for the next year.  The results showed TSH, 3rd Gen at 0.24, and Free T4 at 1.2.  Note that my levels have been very close to this for the past three years - last year's results showed my TSH at 0.6.   I have been on Synthroid 0.075 mcg once daily, and Cytomel 5 mcg twice daily.  I had to stop him though and tell him of the symptoms I have been having over the past year.  I have gained 15 pounds, most of the last 8 pounds in just three months.  I have tried to exercise (which I used to do regularly) but I don't sleep well at night, I'm most of the time fatigued, and when I do have the energy to exercise I have to be careful to plan it because it wears me out for days and I can't keep up with my daily chores from the tiredness.  I've tried Weight Watchers several times, but can't make it through a week without feeling like I'm starving.  I feel like the hunger totally overwhelms me and my appetite takes control.  I've also recently had more than usual hair loss, and I worry a lot more about things.  I'm also hot at night and wake from this feeling, but I've been attributing it to pre-menopausal symptoms (I'm 46) but have had no other related symptoms.

My doc told me to try easing back on the Cytomel for 30 days (only take the morning dose) and then see how I feel.  Should this help?  What should I expect to see/measure against in 30 days so that I can tell if this is working for me?  Is there anything else additionally I should be doing during this time?

Thanks for any help!

[thyroidpal]

Hi and thank you so much for responding. No, my doctor hasn't ordered FT3 since 05.  You think I should have this tested as well?  What would this help with?  When it was tested, it was at 3.5 and then at 4.1.  I have not had my vitamin and B12 levels tested.  However, each year he also runs a basic metabolic panel, along with BUN, Creatinine, eGFR, BUN, Creatinine Ratio, Sodium, Potassium, Chloride, Carbon Dioxide, and Calcium.  All were in range.  I've also been at times tested for Ferritin levels tested, coming in at between 32 - 44,

Should I possibly see my GP for other tests?  What outside of the above would you recommend she look at?

Thanks again!

[Roxannasy]

I am hypo since several years, started with 25, then 50, 75 now 100mcg. Since My endocrinologist put me on 100 mcg I have gained weight. I do not know what to do with my self? Shall I go back to him and tell him about the weight gain? Even though he told me I will loose weight when he increased the dose...

[Barb135]

What are your Free T4 and Free T3 levels?  Just because your endo increased your dosage, doesn't mean it's adequate; obviously, something isn't right.  

If you'll post your latest FT4 and FT3 levels with reference ranges, we'll be able to advise you much better.

[Barb135]

Is it safe to assume that your endo is not ordering Free T3 on you?  

Normally, weight gain is a result of being hypo, while one would associate weight loss with being hyper/over medicated.

I don't know the range for your FT4, but if it's like most we see, yours is almost mid range, which is about where many people need it to be.  Without an FT3, though, it's really hard to say what's going on.

Have you had your vitamin D and B12 levels tested?  Deficiency in either/both can cause some of your symptoms, as well; particularly, fatigue if B12 levels are low.